Leonardi, Andrea;
Bozkurt, Banu;
Silva, Diana;
Mortz, Charlotte G;
Baudouin, Christophe;
Atanaskovic-Markovic, Marina;
Sharma, Vibha;
... Delgado, Luis; + view all
(2025)
Drug-Induced Periocular and Ocular Surface Disorders:
An EAACI Position Paper.
Allergy
, 80
(11)
pp. 2953-2972.
10.1111/all.70074.
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Abstract
Various systemic and topical medications can induce ocular and periocular cutaneous adverse effects (AEs), ranging from mild to severe. These AEs may lead to ocular surface (OS) damage and, in some cases, life-threatening complications. Drug-induced ocular adverse reactions are generally classified into two primary categories: toxic reactions and/or allergic hypersensitivity reactions, which can be IgE or non-IgE-mediated. Systemic antibiotics, antivirals, and anticonvulsants can trigger adverse reactions that may involve the OS. Drugs like antihistamines, beta-blockers, antipsychotics, antidepressants, and isotretinoin are linked to dry eye disease. Topical treatments—including antibiotics, antiglaucoma medications, preservatives, contact lens solutions, and cosmetics—may elicit allergic or toxic ocular diseases. Recent evidence implicates ocular surface AEs in patients undergoing biological treatments for oncological diseases and atopic dermatitis. Epidermal growth factor receptor inhibitors, used in the treatment of several cancers, have been associated with conjunctivitis, meibomitis, dry eye, periocular skin changes, and trichomegaly. Similarly, dupilumab, the first biologic approved for treating moderate-to-severe atopic dermatitis, has also been linked to OS disease with blepharoconjunctivitis. This position paper provides a comprehensive overview of the clinical presentations, diagnostic approaches, and treatment strategies for drug-induced ocular AEs, integrating the latest literature and clinical guidelines.
| Type: | Article |
|---|---|
| Title: | Drug-Induced Periocular and Ocular Surface Disorders: An EAACI Position Paper |
| Location: | Denmark |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1111/all.70074 |
| Publisher version: | https://doi.org/10.1111/all.70074 |
| Language: | English |
| Additional information: | Copyright © 2025 The Author(s). Allergy published by European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License, https://creativecommons.org/licenses/by/4.0/, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
| Keywords: | Biological treatments; drug related blepharoconjunctivitis; ocular allergy; ocular drug hypersensitivity reactions; severe cutaneous adverse reactions |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Institute of Ophthalmology |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10219200 |
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